BYOB Client Intake Form

B.Y.O.B. is not a therapeutic or clinical service, and we are not equipped to support situations involving emotional distress, trauma processing, or safety concerns.

If you’re struggling, we strongly encourage you to contact a licensed mental health professional or a crisis line for immediate support.

988 Suicide & Crisis Lifeline(U.S.): Call or Text 988

Crisis Text Line: Text HOME to 741741

Or visit findahelpline.com for resources by country

Before you continue:

Again this is not a therapy service. It’s a real-world confidence tool built for people who feel ready to try something new.

If you’re unsure whether this is the right fit, we recommend visiting our [Client Readiness Page] before submitting this form. You can also pause here and return when you feel more certain.

By checking the box below, you acknowledge that you understand the purpose of B.Y.O.B. and are choosing to participate voluntarily.

Checkbox:*

I understand that B.Y.O.B. is not therapy and I am choosing to participate voluntarily.Required: YesIf you’re currently in crisis or need mental health support:

Name*

First NameLast Name

Email*

example@example.com

What city are you located in (or near)?*

How did you hear about us?*

What interests you most about this service?*

How are you feeling about trying this?*

I’m excited — I’ve been waiting for something like thisI’m nervous, but curiousI’m skeptical, but willing to exploreI’m unsure — I just want to see what this is

Do you currently have a support system or someone you talk to regularly about confidence or self-image?

Now we get to the heart of it: Tell us your story. What do you want someone to know about you? (The more detail, the better.)*

If you already know who might be around during the moment — or what kind of setting it will be — feel free to share anything about the vibe or tone.

(For example: “It’s a casual group of friends,” or “It’ll be a professional networking thing and I’ll probably be nervous.” This just helps us support you in a way that fits.)

This your chance to tell us a bit about the people might be around the night when the moment happens. (We know things change, and this might not be the exact situation, but anything you share still helps.)*

Who do you imagine being around when this happens?*

StrangersPeople I know casuallyClose friends or familyNot sure yet

When would you ideally want this to take place?*

Date

Ethical Use Confirmation*

I confirm this is not being used to mislead someone for financial, legal, or romantic purposes.

If the option existed, would you feel more confident trying this after speaking with someone trained to help you think through it emotionally?*

Yes, that would help me feel more readyNo, I’d be comfortable deciding on my ownNot sure yet

Actor Prep Call Overview

Part of how B.Y.O.B. works is through improv bit this isn’t a skit or joking around.

Our actors build realistic, low-key support based on real details about you. That’s what makes the moment believable.

Before any live interaction, you’ll need to jump on a quick 5–10 minute call (Zoom or phone — your choice) with the actor assigned to your moment.

This call helps:

– Build a bit of natural rapport

– Go over basic timing and logistics

– Make sure everyone feels comfortable

We strongly recommend Zoom since seeing each other helps with recognition the day of — but a voice call is also okay if that’s your preference.

Jumping on a Call*

I understand that a short call (5–10 min) with the assigned actor is required before my moment.

Taking a Photo*

I agree to provide a recent photo of myself so the actor can recognize me when the moment happens.

Take Photo

I understand that my submission does not guarantee acceptance. B.Y.O.B. reserves the right to determine whether a match is possible based on available actors, timing, or service fit.

I understand that B.Y.O.B. reserves the right to decline or refund any submission if it falls outside the scope or intent of the service.